Slippery Elm

What is slippery elm?

Slippery elm (Ulmus rubra, previously Ulmus fulva) is an herbal supplement made from the inner bark of the slippery elm tree (also known as red elm, gray elm, or soft elm). It is taken by mouth to relieve cough and gastrointestinal problems such as diarrhea and stomach upset in dogs and cats.

The active ingredient is a mucilage, which is a substance that becomes viscous and gel-like when mixed with water, so it acts as a protective coating in the stomach and intestines. It also contains antioxidants that are considered helpful for treating inflammation. In humans, it has been used topically to treat skin inflammation or wounds. 

While many supplements are sold over the counter, they still contain ingredients that have biological effects that should be managed by your veterinarian. Follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label. 

The U.S. Food and Drug Administration (FDA) does not review non-drug health products (e.g., herbals, nutraceuticals, shampoos, and other supplements) for safety or effectiveness before they are sold to the public. Manufacturers of non-drug health products must ensure their products are safe and labeled accurately. The FDA requires that these non-pharmaceuticals contain a disclaimer that says, “This product is not intended to diagnose, treat, cure or prevent any disease.” Health Canada licenses “veterinary health products” after reviewing safety, efficacy, and manufacturing information provided by the manufacturer. These products are not tested by Health Canada. 

Your veterinarian is the best source of information about the safety of non-drug health products in pets. Just because a product is natural does not mean it is safe. All medicines and medicinal plants are potentially toxic if used inappropriately or given at high doses. Supplements can also have side effects, like pharmaceuticals. Few supplements and herbs have been subjected to rigorous scientific trials to determine their efficacy.   

Although the information in this handout may be helpful, it also may be incomplete and may not represent the full range of effects the supplement could have on your pet.

How effective is slippery elm? 

No known studies have been performed in animals, and a limited number of studies have been performed in humans. However, there is anecdotal evidence that slippery elm works to treat stomach upset and inflammation through its ability to coat surfaces and its antioxidant properties. 

How is slippery elm given?

• Slippery elm is given by mouth in the form of a tablet, capsule, powder, or liquid.
• Measure liquid forms carefully.
• The powder is typically mixed with water prior to administration.
• Slippery elm may be given with or without food.
• If stomach upset occurs after dosing on an empty stomach, give future doses with food.
• Dosing recommendations will depend on your pet’s condition, so follow your veterinarian’s instructions.
• Do not give slippery elm within 2 hours of any other medications as it may affect absorption of those medications.

What if I miss giving my pet the supplement?

If you miss a dose, give it as soon as you remember. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects?

• Currently, there are no known side effects. Studies are limited.
• Side effects may occur. If you notice anything unusual, discontinue use and contact your veterinarian immediately.

Are there any risk factors for this supplement? 

DO NOT USE slippery elm in pets that:

• Are allergic to it
• Are pregnant or nursing (safe use has not been established)

Are there any drug interactions I should be aware of?

Slippery elm should not be given within 2 hours of any other medications as it may affect absorption of those medications.

Vitamins, herbal therapies, and supplements have the potential to interact with each other, as well as with prescription and over-the-counter medications. It is important to tell your veterinarian about any medications (including all vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is there any monitoring that needs to be done with this supplement?

• Your veterinarian will let you know when and how they want to reassess your pet to ensure the supplement is working and not causing side effects.
• At home, monitor for any abnormal changes. If any occur, discontinue the supplement and contact your veterinarian.

How do I store slippery elm?

• Store slippery elm in a cool place, protected from light and moisture.
• Follow the specific storage instructions on the product label.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms. Adverse effects should also be reported to the FDA or Health Canada.